Mandates all health insurance contracts, plans, or policies provide the same reimbursement to independent healthcare facilities as that of hospital affiliated facilities where the same healthcare service is provided.
Requires insurance companies to prove that a healthcare service or procedure is not medically necessary.
Amends powers/duties of the office of the health insurance commissioner to increase total cost of care for services reimbursed under contracts after risk adjustment that exceeds the Consumer Price Index for all Urban Consumers percentage increase.
Amends powers/duties of the office of the health insurance commissioner to increase total cost of care for services reimbursed under contracts after risk adjustment that exceeds the Consumer Price Index for all Urban Consumers percentage increase.
Establishes the right of a medical practitioner, healthcare institution, or healthcare payer not to participate in or pay for any medical procedure or service this violates their conscience.
Authorizes a physician practice to charge a practice support contribution; provided that, the amount does not exceed $120 per year, per patient, enrolled in a healthcare insurance plan, (excluding Medicaid and traditional Medicare).
Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.
Requires each healthcare entity/network plan to compile/report to health insurance commissioner a summary of how the healthcare entity/network plan requires its contracted providers to submit claims for in-network outpatient behavioral health services.
Provides for equal pay for healthcare providers.
Removes the age restriction for benefits coverage and requires, for health insurance policies issued or renewed on or after January 1, 2026, that coverage must include reimbursement for applied behavior analysis provider services.